Histopathological analysis of 40 patients with bilateral breast cancer

Abstract

Objective To find an easy and proper way to differentiate metastatic breast cancer from second primary breast cancer by analyzing the histopathological characteristics of 40 patients with bilateral breast cancer. Methods According to the Chaudary histological criteria, the histopathological and biological characteristics of 16 cases of synchronous bilateral breast cancer and 24 cases of metachronous bilateral breast cancer were evaluated. The histopathological and biological characteristics included Nottingham histological grade, immunohistochemistry (IHC) results of the estrogen receptor, progesterone receptor and expression of Her-2. Results The average age of the 40 patients at first diagnosis was 41 years old (range, 26-68 years old). The average time interval between first and second diagnosis of tumors was 34 months (range, 7-209 months) in metachronous cancer. The concordant histopathological type was found in 93.8 % (15/16) of synchronous cancer patients and 58.3 % (14/24) of metachronous cancer patients (P= 0.02). The concordance rates of tumor stage was 68.8 % (11/16) in synchronous cancer patients, while it was 25.0 % (6/24) in metachronous cancer patients (P= 0.03). For progesterone receptor status, the concordance rates were 87.5 % (14/16) and 54.2 % (13/24) in synchronous and metachronous cancer patients respectively (P= 0.03). There was no statistically significant difference in terms of estrogen receptor status and Her-2 expression (P> 0.05). Conclusions Without considering the limitation of Chaudary criteria and the number of patients, it seems to be an easy and proper way to differentiate metastatic cancer from second primary cancer in the patients with bilateral breast cancer by combining the histopathological type, tumor stage and progesterone receptor status. The synchronous cancer is closer to same clonal lesion (metastatic lesion). Key words: Breast neoplasms, bilateral; Histology; Biological markers